Above average — CMS composite of the measures below.
A standard survey is most likely before around October 2026
Estimate from public CMS data, current as of July 2026. Survey timing is at the state agency's discretion.
Citation history
Health deficiencies cited at Coventry Meadows during CMS and state inspections, most recent first.
A resident with multiple medical conditions, including chronic kidney disease, anemia, and recent C. diff infection requiring antibiotics and IV fluids, was assessed as a moderate fall risk and needed assistance with transfers and toileting. While being assisted to the toilet by a CNA, the resident began vomiting, a new symptom, and the CNA left the resident unattended on the toilet to get an LPN instead of staying and using the call light or calling out for help. When staff returned, they found the resident face down on the bathroom floor with a head laceration and vomit on the floor; the resident reported passing out and not remembering the event. Facility documentation and hospital records described the fall as unwitnessed and attributed it to hypovolemia and a vasovagal response, and staff interviews confirmed that residents should not be left alone on the toilet during such a change in condition, despite a practice of leaving residents alone when staff felt they were safe.
A resident with a cerebral infarction diagnosis was found lying on a floor mat with a purple bruise on the right wrist after an unwitnessed fall. The CNA assisted the resident back to bed with help from three staff members, and the only documented event was a skin report for the wrist bruise. The DON could not locate a fall event, neuro checks, or other assessments related to the incident.
A resident with severe dementia in a memory care unit was physically abused by a CNA after the resident became agitated and hit the CNA. The CNA responded by striking the resident on the shoulder, violating the facility's abuse prohibition policy. The incident was reported, and the resident was assessed for injuries and distress.
Resident Left Unattended on Toilet During Vomiting Leads to Unwitnessed Fall and Head Injury
Penalty
Summary
The deficiency involves the facility’s failure to ensure adequate supervision and prevent accident hazards for a resident who experienced a change in condition while on the toilet. A resident with diagnoses including chronic kidney disease, hypertension, anemia, asthma, and a left great toe amputation was admitted with a moderate fall risk and care plan indicating the need for assistance or supervision with mobility, transfers, ambulation, and toileting. Functional assessments documented that the resident required partial to moderate assistance with toileting and transferring, and nursing notes indicated the resident needed 1–2 person assistance with transfers. The resident had recently tested positive for C. difficile, was receiving antibiotics and IV fluids, and had been experiencing diarrhea. On the day of the incident, the resident was assisted to the toilet by a CNA and began vomiting, which was a new symptom according to the ADON. Despite this change in condition, the CNA left the resident alone on the toilet to get the nurse, rather than remaining with the resident and using the call light or calling out for help, as later described by interviewed staff as the expected practice when a resident vomits on the toilet. When the nurse and CNA returned, they found the resident face down on the bathroom floor with a laceration on the right side of the head and vomit present on the floor. The fall was unwitnessed, and the resident reported having passed out and not remembering what happened. Facility documentation, including fall event and investigation reports and an interdisciplinary note, confirmed that the resident had been left unattended on the toilet during vomiting and was later found on the floor with a head injury. Hospital emergency department records indicated the fall was due to hypovolemia and a vasovagal response. The facility’s fall management policy identified all new admissions as fall risks, but staff practice allowed residents to be left alone on the toilet when staff felt they were safe, contributing to the circumstances of this incident.
Incomplete Follow-Up After Unwitnessed Fall
Penalty
Summary
The facility failed to complete follow-up for an unwitnessed fall involving Resident 3, whose diagnosis included other cerebral infarction due to occlusion or stenosis of a small artery. Progress notes documented that a CNA reported the resident was lying on the floor mat with a purple bruise on the right wrist and that the resident was assisted back to bed with help from three staff members. The immediate intervention recorded was to encourage the resident to use the call light for assistance. An event report was completed for right wrist bruising, but no other event reports or fall documentation were found for the unwitnessed fall, and the DON stated the facility could not locate a fall event, neurological checks, or other assessments related to the incident.
Failure to Protect Resident from Physical Abuse
Penalty
Summary
The facility failed to protect a resident's right to be free from physical abuse. The incident involved a resident with severe dementia and behavioral disturbances, who was residing in a secured memory care unit. The resident, identified as having severely impaired cognition and requiring moderate to full assistance with daily activities, exhibited behaviors such as hitting and kicking staff during care. On the day of the incident, the resident was agitated and hit a Certified Nurse Aide (CNA) while being assisted with dinner. In response, the CNA struck the resident on the back of the shoulder with an open hand. The incident was reported to the Indiana Department of Health, and the facility's administrator was notified. The CNA involved claimed the action was a reflexive response to being punched by the resident. The facility's policy on abuse prohibition was not adhered to, as the resident was not protected from physical abuse. The incident was witnessed by staff, and a video recording was reviewed as part of the investigation. The resident was assessed for injuries and monitored for any psychosocial distress following the incident.
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Resident with a documented fall history left unattended on the patio; found on the ground with a hip fracture.
Walk-in cooler logs missing for 12 days; expired supplements in the medication room fridge.
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Nursing homes near Fort Wayne
How nearby facilities compare on the same public inspection record.
| Facility | Distance | Overall rating | Citations, 12 mo | Serious (J–L) |
|---|---|---|---|---|
| Sage Bluff Health And Rehab Center | 0.1 mi | ★★★★★ | 6 | 0 |
| Majestic Care Of Jefferson Pointe | 1.7 mi | ★★★★★ | 18 | 1 |
| Englewood Health & Rehabilitation Center | 3.5 mi | ★★★★★ | 0 | 0 |
| Majestic Care Of Fort Wayne | 5.3 mi | ★★★★★ | 2 | 0 |
| Majestic Care Of West Allen | 5.6 mi | ★★★★★ | 10 | 1 |
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Trusted data, never guesswork. Every citation, penalty, rating and Plan of Correction on this page is sourced from public CMS records (latest release July 2026) and official state health department websites.